Mental Health & Learning Disabilities Delivery Unit

Home , Clydach (electoral ward), Morriston, Swansea

APPENDIX 1

Part 1 – Sickness Absence April 2017 – March 2018

Rolling 12 Month In Month Absence (LTS and STS)

The rolling 12 month sick absence rate was 6.12% in March Both short & long term absence has decreased from 18, which decreased from 6.33% in March 17. The in month January through to March 2018. Short term absence has rate was 5.63% in March 18, which decreased from 6.59% in increased overall from 1.34% in March 2017 to 1.70% in March 17. March 2018. The majority of the DU sickness is long term absence, which reduced overall from 5.25% in March 2017 to 3.93% in March 2018.

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Length of Absence The chart below shows that the majority of absences are between 28 days and 6 months. This is a similar pattern to that over the last 12 months.

Delivery Unit performance August 17 to March 2018 The DU had enjoyed a reducing trend in its total in month and rolling absence position from December 2017 to March 2018. In month +/- on previous month Cumulative +/- on previous month August 2017 6.64% 6.23% September 2017 5.95% - 0.69% 6.21% - 0.02% October 2017 5.78% -0.17% 6.23% + 0.02% November 2017 6.07% +0.29% 6.23% No change December 2017 6.57% +0.5% 6.28% +0.05% January 2018 6.25% -0.32% 6.17% -0.11% February 2018 5.89% -0.36% 6.15% -0.02%

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March 2018 5.63% -0.26% 6.12% -0.03%

Actions taken/completed Actions planned for April/May  Continuation of the ABMU Flu Campaign.  Sick Absence audits continuing across DU Localities.  Following Hot Spot area audits, sickness process  Reviewing medical staff sick absence reporting and training has been reviewed and further back to basics actions taken as part of Medical Workforce Meeting. HR training held on 17 & 27 April.  DU hot spot analysis across all localities.  140 DU managers have attended Nelson Training.  Review of top 10 long term sickness cases on a  Guy Holt and Paul Dunning attended DU Workforce monthly basis in Locality Sickness meetings. meeting in April to discuss further ways to assist and  Taster sessions for Art Therapy project to improve staff improve staff health and wellbeing. health and wellbeing were held on 19/20th March 2018.  Art Therapy Pilot Taster Sessions held on 19 & 20 Feedback from participants was extremely positive and March 2018. Application for pilot project has been Steering group met on 3 May and in process of submitted to Arts Council Wales. agreeing pilot areas. Application for further funding from Arts Council Wales has been submitted.  Funding has been secured to pilot DU Staff Counsellor for 12 months in Specialist Services Locality. Job description has recently been approved and is now proceeding through recruitment process.  DU supported 47 Wellbeing Champions and each Locality reviewing how they can best be utilised to support staff health and wellbeing.  Review being undertaken of attendance of Band 7 managers at monthly Locality Sickness Meetings. This is main lessons learnt following best practice review undertaken with POW DU.

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Part 2 – Establishment, Vacancies and Recruitment – March 2018

Budget SIP Detail -Under / Over Directorate Staff Category Wte FTE Establishment MH & LD Delivery Unit Admin & Clerical 203.66 190.46 -13.20 Consultant 47.90 42.90 -5.00 Other 321.68 266.81 -54.87 Other Medical Staff 79.61 47.46 -32.15 Qualified Nurse 825.38 739.77 -85.61 Unqualified Nurse 670.50 615.07 -55.43

MH & LD Delivery Unit Totals 2,148.73 1,902.48 -246.25

 Planned reinvestment into Community services enable the planned ward closures within Older Peoples Services. As the ward closures are not agreed, their respective WTE remains, therefore, overstating the vacancy position by 42 WTE within qualified and unqualified nursing.  The Delivery Unit has two main areas of recruitment difficulty, substantive medical appointments and qualified nursing. The shortfalls in qualified nursing are mostly within Learning Disabilities, Forensic and Rehab Services. Specialist Services Locality has the largest amount of Nursing vacancies at 52 WTE of which 42.5 WTE are either awaiting commencement or are in recruitment.  The Delivery Unit is presently utilising 10 MEDACs locums to backfill 20 medical vacancies. The remainder is covered via additional sessions or remaining vacant. The Delivery Unit Medical Workforce Group are pursuing strategies to substantively recruit.

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Part 3 - Turnover & Labour Stability

Period Turnover Rate – 1 April 2017 – 31 March 2018

Staff Group FTE Average turnover has decreased over the last Add Prof Scientific and Technic 18.63% few months to 8.63% as at 31 March 2018. Nursing turnover was of concern as it had been Additional Clinical Services 8.30% as high as 11.89% in the last 12 months, mainly Administrative and Clerical 7.36% due to high level of retirements. The nursing Allied Health Professionals 7.82% turnover has now reduced to 9.17% in March 2018. Estates and Ancillary 7.00% DU had 12 leavers with less than 12 months Medical and Dental 5.42% service, 6% of total leavers. Nursing and Midwifery Registered 9.17% .

Health Board - Excluding Junior Medical & Dental Staff & Students Overall Rate 8.63%

Actions taken/completed Actions planned for April/May  Leaver’s data is circulated on a monthly basis to all  DU update analysis of leavers to establish patterns Localities as part of the DU HR report to Board. and check on concerns over staff leaving within the  DU took part in two HB Nurse Recruitment events in first year of their appointment with a focus on nursing. both Morriston and POW and successfully recruited to  Each Locality is undertaking an exercise for all staff posts at both events. groups to ascertain a more informed picture of  Implemented values based recruitment for all inpatient predicted retirements over next 3-5 years. registered nursing roles and generic job descriptions  DU will continue to take part in HB wide Nurse from 1 April 2018. Recruitment events on a rolling basis.

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Part 4 – PADR April 2018

Org L6 Org L8 Assignment Reviews Reviews Completed Count Completed % 130 Head of Operations - Dir 130 R001 Mental Health Directorate Support 5 2 40.00 130 Head of Operations - Dir 130 R004 Joint Training & Education 1 1 100.00 130 Head of Operations - Dir 130 R005 Mental Health Administration 37 27 72.97 130 Head of Operations - Dir 130 R008 Mental Health Directorate Management 8 7 87.50 130 Head of Operations - Dir 130 T013 Special Projects Team 1 0 0.00 130 Head of Operations - Dir 130 T014 Directorate Team 3 2 66.67 130 Head of Psychology & Therapies 130 R210 Professional Heads of Therapies 4 4 100.00 130 MHLD Bridgend Locality - Dir 130 R016 MH Measure Bridgend 11 11 100.00 130 MHLD Bridgend Locality - Dir 130 R024 ARC Day Opportunities 4 2 50.00 130 MHLD Bridgend Locality - Dir 130 R030 Bridgend MH Comm Serv 10 8 80.00 130 MHLD Bridgend Locality - Dir 130 R032 Bridgend Psychology 3 3 100.00 130 MHLD Bridgend Locality - Dir 130 R034 PICU Coity Clinic 28 26 92.86 130 MHLD Bridgend Locality - Dir 130 R037 South Bridgend CMHT 16 16 100.00 130 MHLD Bridgend Locality - Dir 130 R038 North Bridgend CMHT 20 20 100.00 130 MHLD Bridgend Locality - Dir 130 R107 Perinatal MH Services 9 4 44.44 130 MHLD Bridgend Locality - Dir 130 R111 Coity Clinic Ward 14 28 27 96.43 130 MHLD Bridgend Locality - Dir 130 R112 Coity Clinic Ward 21 24 24 100.00 130 MHLD Bridgend Locality - Dir 130 R113 OT & Physio Adult Bridgend 5 5 100.00 130 MHLD Bridgend Locality - Dir 130 R115 Bridgend Crisis Team 20 17 85.00 130 MHLD Bridgend Locality - Dir 130 R121 MH Bridgend OT OPS 4 3 75.00 130 MHLD Bridgend Locality - Dir 130 R129 Bridgend Continuing Health Care 17 17 100.00 130 MHLD Bridgend Locality - Dir 130 R131 Angelton Clinic Ward 1 17 16 94.12 130 MHLD Bridgend Locality - Dir 130 R133 Angelton Clinic Ward 3 16 16 100.00 130 MHLD Bridgend Locality - Dir 130 R134 Coity Clinic Ward 15 21 20 95.24 130 MHLD Bridgend Locality - Dir 130 R135 Angelton Clinic Ward 2 28 26 92.86

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130 MHLD Bridgend Locality - Dir 130 R136 EMI Teams 14 14 100.00 130 MHLD Bridgend Locality - Dir 130 R201 MH Community Drug & Alcohol 6 2 33.33 130 MHLD Bridgend Locality - Dir 130 R202 Home Detox 2 2 100.00 130 MHLD Bridgend Locality - Dir 130 R203 SMAP Funding 5 5 100.00 130 MHLD Bridgend Locality - Dir 130 R204 Bridgend Assessment Service 1 0 0.00 130 MHLD Bridgend Locality - Dir 130 R610 Bridgend Locality Management 6 5 83.33 130 MHLD Bridgend Locality - Dir 130 T006 LD Dietician 4 3 75.00 130 MHLD Bridgend Locality - Dir 130 T007 LD Art Therapy 4 2 50.00 130 MHLD Bridgend Locality - Dir 130 T010 LD Administration 19 16 84.21 130 MHLD Bridgend Locality - Dir 130 T017 Community Health Team - Bridgend 18 18 100.00 130 MHLD Bridgend Locality - Dir 130 T018 Community Health Team - Cardiff 32 29 90.63 130 MHLD Bridgend Locality - Dir 130 T019 Community Health Team - Vale 14 12 85.71 130 MHLD Bridgend Locality - Dir 130 T020 Community Health Team - RCT East 9 9 100.00 130 MHLD Bridgend Locality - Dir 130 T021 Community Health Team - RCT West 14 12 85.71 130 MHLD Bridgend Locality - Dir 130 T022 Community Health Team - Merthyr 7 7 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 N028 Occupational Therapy OPS NPT 12 11 91.67 130 MHLD Neath Port Talbot Locality - Dir 130 R002 Mental Health Veterans Service 5 3 60.00 130 MHLD Neath Port Talbot Locality - Dir 130 R007 NPTH MH Administration 7 7 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R020 Psychological Therapies Bridgend 2 1 50.00 130 MHLD Neath Port Talbot Locality - Dir 130 R053 Dechrau Newydd 4 3 75.00 130 MHLD Neath Port Talbot Locality - Dir 130 R058 NPT MH Measure 20 19 95.00 130 MHLD Neath Port Talbot Locality - Dir 130 R062 South Community MH Team 10 9 90.00 130 MHLD Neath Port Talbot Locality - Dir 130 R063 North Community MH Team 13 12 92.31 130 MHLD Neath Port Talbot Locality - Dir 130 R064 Neath Psychology 5 4 80.00 130 MHLD Neath Port Talbot Locality - Dir 130 R067 NPTH Ward F Acute 28 23 82.14 130 MHLD Neath Port Talbot Locality - Dir 130 R068 NPTH Recovery Unit 3 3 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R069 NPT Assertive Outreach Team - NPTH 6 6 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R070 NPTH CRHT Team 13 11 84.62

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130 MHLD Neath Port Talbot Locality - Dir 130 R079 First Episode Psychosis 5 5 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R102 NPT Detox Ward 14 14 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R105 Occupational Therapy Adult NPT 6 6 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R140 Tonna EMI General Admin 11 9 81.82 130 MHLD Neath Port Talbot Locality - Dir 130 R142 Tonna Emi Suite 1 23 23 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R143 Tonna Emi Suite 2 24 23 95.83 130 MHLD Neath Port Talbot Locality - Dir 130 R144 Tonna Suite 3 4 4 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R145 Tonna Emi Suite 4 26 23 88.46 130 MHLD Neath Port Talbot Locality - Dir 130 R146 Tonna EMI Day Hospital 8 4 50.00 130 MHLD Neath Port Talbot Locality - Dir 130 R147 Neath Community Emi 31 30 96.77 130 MHLD Neath Port Talbot Locality - Dir 130 R150 NPTH Ward G EMI 24 24 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R151 NPTH Day Hospital G 5 5 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R156 Young Onset Dementia Service 1 1 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R157 Dementia Services - OP/CMHT 11 7 63.64 130 MHLD Neath Port Talbot Locality - Dir 130 R220 MH Comm Drug & Alcohol 7 4 57.14 130 MHLD Neath Port Talbot Locality - Dir 130 R222 Low Threshold Prescribing Service 3 1 33.33 130 MHLD Neath Port Talbot Locality - Dir 130 R225 SMART 2 2 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 R510 Neath Port Talbot Locality Management 3 3 100.00 130 MHLD Neath Port Talbot Locality - Dir 130 T016 Community Health Team - Neath 17 12 70.59 130 MHLD Swansea Locality - Dir 130 R014 CC Medical Records 2 2 100.00 130 MHLD Swansea Locality - Dir 130 R059 MH Eating Disorders 1 1 100.00 130 MHLD Swansea Locality - Dir 130 R077 Assertive Outreach Team - Swansea 12 12 100.00 130 MHLD Swansea Locality - Dir 130 R083 Swansea Psychology 9 8 88.89 130 MHLD Swansea Locality - Dir 130 R084 Fendrod Ward CCH 22 17 77.27 130 MHLD Swansea Locality - Dir 130 R085 Clyne Ward CCH 24 21 87.50 130 MHLD Swansea Locality - Dir 130 R087 Community Acute Area 1 (Central Clinic) 15 13 86.67 130 MHLD Swansea Locality - Dir 130 R088 Community Acute Area 2 (Central Clinic) 20 18 90.00 130 MHLD Swansea Locality - Dir 130 R089 Community Acute Area 3 (Ty-Einon) 29 23 79.31

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130 MHLD Swansea Locality - Dir 130 R092 Crisis Resolution Service 31 16 51.61 130 MHLD Swansea Locality - Dir 130 R093 Adult Liaison Psychiatry 26 15 57.69 130 MHLD Swansea Locality - Dir 130 R104 CC Adult Occupational Therapy 16 16 100.00 130 MHLD Swansea Locality - Dir 130 R106 CC Occupational Therapy 10 10 100.00 130 MHLD Swansea Locality - Dir 130 R109 Occupational Therapy Management 3 1 33.33 130 MHLD Swansea Locality - Dir 130 R110 CC Physiotherapy 4 4 100.00 130 MHLD Swansea Locality - Dir 130 R127 MH Measure Swansea 29 26 89.66 130 MHLD Swansea Locality - Dir 130 R160 CC Onen Ward 34 29 85.29 130 MHLD Swansea Locality - Dir 130 R161 CC Derwen Ward 35 24 68.57 130 MHLD Swansea Locality - Dir 130 R167 Old Age Psych -Nurse Admin 11 8 72.73 130 MHLD Swansea Locality - Dir 130 R168 Memory Clinic 5 3 60.00 130 MHLD Swansea Locality - Dir 130 R170 CC Celyn Ward 35 34 97.14 130 MHLD Swansea Locality - Dir 130 R171 Garngoch Day Hospital 4 4 100.00 130 MHLD Swansea Locality - Dir 130 R172 Westfa Day Care 4 1 25.00 130 MHLD Swansea Locality - Dir 130 R173 EMI Areas 1 & 2 16 16 100.00 130 MHLD Swansea Locality - Dir 130 R174 EMI Areas 3 & 4 15 15 100.00 130 MHLD Swansea Locality - Dir 130 R175 Community In Reach Team - Swansea 9 8 88.89 130 MHLD Swansea Locality - Dir 130 R176 Older Age Liason Psychiatry 1 1 100.00 130 MHLD Swansea Locality - Dir 130 R241 Medical Staff - Substance Misuse 1 1 100.00 130 MHLD Swansea Locality - Dir 130 R244 Community Drugs Team 18 18 100.00 130 MHLD Swansea Locality - Dir 130 R410 Swansea Locality Management 2 2 100.00 130 MHLD Swansea Locality - Dir 130 T015 Community Health Team - Swansea 13 13 100.00 130 Mental Health & Learning Disabilities Management - Dir 130 6F43 Mental Health & Learning Disabilities Unit Management 17 16 94.12 130 Mental Health & Learning Disabilities Management - Dir 130 R003 MH Informatics Team 1 1 100.00 130 Specialist Services - Dir 130 N029 Forensic Occupational Therapy 10 9 90.00 130 Specialist Services - Dir 130 R026 Cefn Yr Afon Quarella Road 26 21 80.77 130 Specialist Services - Dir 130 R055 Cedar Ward 24 22 91.67 130 Specialist Services - Dir 130 R056 Rowan Ward 25 24 96.00

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130 Specialist Services - Dir 130 R057 Taith Newydd Support Services 15 14 93.33 130 Specialist Services - Dir 130 R076 Step Down Unit CCH - Ty Gwanwyn 10 8 80.00 130 Specialist Services - Dir 130 R078 Step Down Unit CCH - Carreg Sarn 11 10 90.91 130 Specialist Services - Dir 130 R091 Criminal Justice Team 13 12 92.31 130 Specialist Services - Dir 130 R097 Gwelfor Unit CC 27 25 92.59 130 Specialist Services - Dir 130 R099 Medical Staffing for Rehab/R 1 0 0.00 130 Specialist Services - Dir 130 R260 Forensic General Services 40 34 85.00 130 Specialist Services - Dir 130 R261 Forensic Prof Support Services 5 5 100.00 130 Specialist Services - Dir 130 R263 Forensic Penarth Ward 36 25 69.44 130 Specialist Services - Dir 130 R264 Forensic Ogmore Ward 29 24 82.76 130 Specialist Services - Dir 130 R265 Forensic Nursing Services 18 14 77.78 130 Specialist Services - Dir 130 R266 Forensic Newton Ward 31 24 77.42 130 Specialist Services - Dir 130 R268 Forensic Cardigan Ward 23 15 65.22 130 Specialist Services - Dir 130 R270 Forensic Tenby Ward 28 20 71.43 130 Specialist Services - Dir 130 R290 Prison In-Reach Team 8 6 75.00 130 Specialist Services - Dir 130 R431 CHC Staffing Costs 11 8 72.73 130 Specialist Services - Dir 130 R710 Specialist Services Locality Management 7 4 57.14 130 Specialist Services - Dir 130 T040 Special Services - Meadow Court 22 18 81.82 130 Specialist Services - Dir 130 T041 Special Services - Dan-y-Bont 19 19 100.00 130 Specialist Services - Dir 130 T042 Special Services - Ty Garth Newydd 20 19 95.00 130 Specialist Services - Dir 130 T043 Special Services - Bryn Afon 17 17 100.00 130 Specialist Services - Dir 130 T044 Special Services - Swyn-y-Afon 17 11 64.71 130 Specialist Services - Dir 130 T045 Special Services - Dan-y-Deri 16 11 68.75 130 Specialist Services - Dir 130 T047 Special Services - Lletty Newydd 23 22 95.65 130 Specialist Services - Dir 130 T060 Special Services - Hafod-y-Wennol 17 16 94.12 130 Specialist Services - Dir 130 T061 Special Services - Llwyneryr 21 18 85.71 130 Specialist Services - Dir 130 T062 Special Services - Laurels & Briary 28 13 46.43 130 Specialist Services - Dir 130 T063 Special Services - Rowan House 23 20 86.96

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130 Specialist Services - Dir 130 T080 Special Services - Facing the Challenge 10 8 80.00 130 Specialist Services - Dir 130 T081 Special Services Behavioural Team 16 15 93.75 Grand Total 1,969 1,680 85.32

Current Position and Background The above provides a breakdown by MH & LD Delivery Unit cost centre PADR completion and recording within Electronic Staff Record (ESR) as a percentage, as of the 30th April 2018 for a 12 month rolling period. The DU’s position has continued to improve and the target of 85% was achieved at the end of April 2018 at 85.32%.

Actions taken/completed Actions planned for April/May  Each Locality nominated a person who now has  Review of PADR compliance is conducted by each business admin rights for ESR access to enter PADR Locality in their monthly sickness/workforce meetings data, who all attended re-training/training in late 2017. and at each DU quarterly performance reviews.  Further work has been undertaken by the DU to  DU will now expect each Locality to maintain the current interrogate the ESR records against local data and position as a minimum going forward and will scrutinise reconcile staff in post information via payroll to performance at quarterly locality performance reviews. accurately reflect current staffing.

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Part 5 - Statutory and Mandatory Training – As per Performance Review Scorecard April 2018 (Nursing Metrics) Competency Compliance % Fire Safety 94.28% Violence and Aggression (Wales) 97.08% Manual Handling 91.33% Hand Hygiene 95.53% Infection Prevention and Control - Level 1 97.39%

Safeguarding Children - Level 1 81.48%

POVA 94.09%

MCA/DOLS 90.85% Information Governance (Wales) 72.00% Dementia awareness 93.79%

ESR Compliance for Mandatory and Statutory training for all staff 64.11%

Actions taken/completed Actions planned for April/Feb  Significant improvements have been shown over the last  Mandatory and statutory training compliance forms part of quarter in mandatory and statutory training compliance. targeted intervention for hot spot areas and reviewed at quarterly Locality performance reviews.  Localities have been asked to review all staff compliance with Information Governance training as a priority.  Focus going forward will be on improving mandatory and statutory training for all staff as recorded on ESR.

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APPENDIX 1

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APPENDIX 1

Morriston Delivery Unit

Part 1 – Sickness Absence 1 April 2017 – 31 March 2018

Rolling 12 month sickness absence

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APPENDIX 1

The rolling 12 month sick absence rate remained the same as the previous month. The in month figure decreased by 0.16%

When compared to March 2017 cumulative sickness absence rate, the unit’s cumulative sickness absence rate has increased by 0.02% during the 12 month period.

In Month Absence

Short term absence has decreased by 0.19% and long term absence has increased by 0.02% for March 2018 against the previous month sickness rates.

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Length of Absence

The chart below shows the length of absences.

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Overall performance March 2018 There has been a decrease in the in month sickness figure whilst the overall cumulative sickness figure has remained the same

In month +/- on previous month Cumulative +/- on previous month Morriston 6.28% - 0.16% 5.95% +0.00% Actions taken April/May Actions planned for June/July  Review of the staff with the longest length of absence  Review of Service Group plans to reduce sickness at reviewed by Senior HR Managers. the weekly business meeting.  Plans to reduce sickness in each Hotspot area have  Further sick absence audits to continue within unit been discussed at the weekly business meeting. during 2018.  Review of long term and short term sickness by the  Review of staff who have sickness of 90 days + by the operational HR team to ensure compliance with the Senior HR Manager Sickness absence policy.  Management Development – support for sickness  Audits undertaken in Hotspot areas. absence training for managers  Management Development – promotion of sickness  Engagement with the Wellbeing champions absence training and Stress Risk Assessment  On-going health and well-being focus in team brief. Workshop for Managers  Implement actions from staff survey action plan  Staff survey action plan reviewed including a newsletter  Support from the Staff Wellbeing programme in Hotspot  Continue to provide Service Groups with detailed areas sickness absence data  Nursing trigger Peer review audits

Part 2 – Establishment, Vacancies and Recruitment

Over the last year or so the Health Board have been developing the ESR system to include an “establishment” figure so that we are able to accurately assess the number of true vacancies at any given time. The work has focused on our operational directorates and in particular nursing given the shortage of qualified nurses available within the employment market.

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APPENDIX 1

ABM Finance Dashboard Summary of Vacancy Details for Morriston SDU April 2018 Data Summarised by Staff Category

Budget SIP Detail -Under / Over Directorate Staff Category Wte FTE Establishment Morriston Delivery Unit Admin & Clerical 481.10 462.90 -18.20 Consultant 278.42 265.58 -12.85 Other 463.22 484.07 20.85 Other Medical Staff 386.43 308.68 -77.75 Qualified Nurse 1,451.59 1,316.02 -135.57 Unqualified Nurse 460.75 492.83 32.08 Morriston Delivery Unit Totals 3,521.51 3,330.08 -191.43

Recruitment and retention of key staff groups- registered nursing and medical staff remain the key problem in terms of the level of vacancies and difficulties in recruitment and retention. The recruitment strategy for qualified nurses has been revisited and the Band 5 recruitment open days have continued along with speciality led adverts. Targeted Nurse retention work has been undertaken in ITU. The Unit has considerable funded nursing establishment deficits compared with previously agreed WG CNO principles & the Nurse Staffing Act. In ED Workforce plan has been developed with skill mix changes agreed to address the deficit in medical staff. There are deficits in the Medicine middle grade rotas from August 2018 and the service is reviewing alternative cover solutions Physician Associate Internships have been introduced in Surgery and Medicine and has been extended to an ED/ ED rotation in 2018/19.

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APPENDIX 1

Part 3 - Turnover & Labour Stability

Staff Turnover – Morriston Hospital - 1 May 2017 to 30 April 2018

Staff Group FTE

Add Prof Scientific and Technic 1.33%

Additional Clinical Services 12.06%

Administrative and Clerical 7.08%

Allied Health Professionals 6.35%

Estates and Ancillary 4.33%

Healthcare Scientists 7.44%

Medical and Dental 10.37%

Nursing and Midwifery Registered 7.60%

2017 / 05 2017 / 06 2017 / 07 2017 / 08 2017 / 09 2017 / 10 2017 / 11 2017 /12 2018/ 01 2018 / 02 2018/03 2018 / 04 Headcount 3,467 3,459 3,459 3,458 3,465 3,478 3,486 3,476 3,475 3,469 3,488 3,467 FTE 3,073.49 3,067.10 3,064.72 3,064.45 3,067.84 3,076.29 3,083.63 3,077.59 3,074.50 3,071.55 3,088.35 3,065.73 Leavers Headcount 30 19 25 21 37 28 22 23 18 22 30 16 Leavers FTE 27.13 16.61 22.51 19.45 33.36 24.83 20.06 19.04 15.82 19.94 25.05 11.87 Starters Headcount 16 19 21 20 36 47 34 13 20 17 27 14 Starters FTE 14.21 16.35 18.63 18.84 33.00 42.41 30.47 12.23 17.54 16.13 24.15 12.90 Maternity 74 76 74 76 75 78 83 82 78 79 81 75

Turnover Rate (Headcount) 0.87% 0.55% 0.72% 0.61% 1.07% 0.81% 0.63% 0.66% 0.52% 0.63% 0.86% 0.46% Turnover Rate (FTE) 0.88% 0.54% 0.73% 0.63% 1.09% 1.81% 0.65% 062% 0.51% 0.65% 0.81% 0.39% Leavers (12m) 309 305 303 300 307 313 309 307 299 299 297 291 Turnover Rate (12m) 8.97% 8.83% 8.76% 8.65% 8.85% 9.01% 8.89% 8.83% 8.60% 8.60% 8.55% 8.38% Leavers FTE (12m) 265.84 263.96 264.50 261.91 267.91 273.85 271.53 269.47 263.61 265.90 263.67 255.67 Turnover Rate FTE (12m) 8.71% 8.63% 8.63% 8.52% 8.71% 8.90% 8.82% 8.75% 8.56% 8.64% 8.57% 8.32%

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Delivery unit - Excluding Junior Medical & Dental Staff & Students Overall Rate 8.51%

Actions taken completed April /May Actions planned for June/July  Exit interviews undertaken to establish the reasons for  DU to continue to undertake exit interviews an review leaving in areas with high turnover. Actions taken to if the actions taken have addressed the concerns address concerns raised where applicable raised.  Staff survey action plan implemented  Continue to promote staff engagement via Team brief  Continue to support staff Wellbeing events

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Part 4 - PADR

Current Position and Background

The following provides a breakdown of the Morriston Delivery Unit PADR completion and recording within ESR as a percentage as at 30th April 2018 for a 12 month rolling period.

PDR Reviews - SDU - Morriston Hospital - excluding Medical and Dental 1st May 2017 – 30th April 2018

Org L6 Org L8 Assignment Reviews Reviews Completed Count Completed % 130 MN Clinical Services Group - Dir 130 A105 MN Anaesthetics 7 7 100.00

130 MN Clinical Services Group - Dir 130 A111 West Pain Service 5 2 40.00

130 MN Clinical Services Group - Dir 130 A201 POW HSDU 30 11 36.67

130 MN Clinical Services Group - Dir 130 A202 MN HSDU 60 41 68.33

130 MN Clinical Services Group - Dir 130 A203 SN HSDU 32 28 87.50

130 MN Clinical Services Group - Dir 130 A210 HSDU Management 1 1 100.00

130 MN Clinical Services Group - Dir 130 A303 West Outreach 3 3 100.00

130 MN Clinical Services Group - Dir 130 A311 West Critical Care 209 158 75.60

130 MN Clinical Services Group - Dir 130 A312 Critical Care Medical Staff 5 1 20.00

130 MN Clinical Services Group - Dir 130 A313 Vascular Access Service 3 2 66.67

130 MN Clinical Services Group - Dir 130 A406 West Pre-Assessment 19 16 84.21

130 MN Clinical Services Group - Dir 130 A423 MN Theatres 269 178 66.17

130 MN Clinical Services Group - Dir 130 A430 Theatre Support Staff & Management 17 11 64.71

130 MN Clinical Services Group - Dir 130 A501 CSS Directorate Management 8 7 87.50

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130 MN Clinical Services Group - Dir 130 D611 MN MRI 9 9 100.00

130 MN Clinical Services Group - Dir 130 D612 SN Radiology 65 61 93.85

130 MN Clinical Services Group - Dir 130 D614 MN Medical Photography 6 5 83.33

130 MN Clinical Services Group - Dir 130 D615 SN Medical Photography 1 1 100.00

130 MN Clinical Services Group - Dir 130 D616 MN Radiology 116 97 83.62

130 MN Hospital Operations & Emergency Care - Dir 130 6B21 Resuscitation Training 8 6 75.00

130 MN Hospital Operations & Emergency Care - Dir 130 F210 MN Emergency Department - Non Medical 133 87 65.41

130 MN Hospital Operations & Emergency Care - Dir 130 F212 ED Admin Staff 19 13 68.42

130 MN Hospital Operations & Emergency Care - Dir 130 P410 MN General Admin 7 6 85.71

130 MN Hospital Operations & Emergency Care - Dir 130 P422 West Bed Management 21 17 80.95

130 MN Hospital Operations & Emergency Care - Dir 130 P460 MN Social Work Office 2 1 50.00

130 MN Hospital Operations & Emergency Care - Dir 130 P461 Operational Services Manager 10 4 40.00

130 MN Medicine Service Group - Dir 130 F102 Medicine Services Directorate Support 10 7 70.00

130 MN Medicine Service Group - Dir 130 F103 Respiratory Nursing 11 7 63.64

130 MN Medicine Service Group - Dir 130 F206 Acute Medical Assessment Unit (East) 44 23 52.27

130 MN Medicine Service Group - Dir 130 F213 CDU Admin Staff 5 3 60.00

130 MN Medicine Service Group - Dir 130 F313 MN Respiratory Medicine 2 2 100.00

130 MN Medicine Service Group - Dir 130 F314 MN General Medicine 1 1 100.00

130 MN Medicine Service Group - Dir 130 F315 Ward S 42 11 26.19

130 MN Medicine Service Group - Dir 130 F316 Morriston Anglesey Ward 39 28 71.79

130 MN Medicine Service Group - Dir 130 F317 MN Gower Ward 32 26 81.25

130 MN Medicine Service Group - Dir 130 F329 MN Ward D 47 19 40.43

130 MN Medicine Service Group - Dir 130 F401 MN Renal Medicine 17 5 29.41

130 MN Medicine Service Group - Dir 130 F402 MN Renal Main & Acute Dialysis 42 18 42.86

130 MN Medicine Service Group - Dir 130 F403 MN Cardigan Renal Ward 39 16 41.03

130 MN Medicine Service Group - Dir 130 F404 ESA Repatriation 2 1 50.00

130 MN Medicine Service Group - Dir 130 F410 MN Renal Medicine Pharmacy 8 8 100.00

130 MN Medicine Service Group - Dir 130 F412 MN Renal HVS 30 15 50.00

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130 MN Medicine Service Group - Dir 130 F413 MN Renal Community Team 17 2 11.76

130 MN Medicine Service Group - Dir 130 F414 MN Renal Specialist Nurses 11 6 54.55

130 MN Medicine Service Group - Dir 130 F504 MN Diabetology 11 3 27.27

130 MN Medicine Service Group - Dir 130 F533 MN Gastroenterology 4 3 75.00

130 MN Medicine Service Group - Dir 130 F541 Neurology Nursing 10 8 80.00

130 MN Medicine Service Group - Dir 130 F542 Regional Neuropsychology & Brain Injury Service 2 1 50.00

130 MN Medicine Service Group - Dir 130 F545 MN Clinical Neurophysiology 9 8 88.89

130 MN Medicine Service Group - Dir 130 F546 MN Neurology 13 9 69.23

130 MN Medicine Service Group - Dir 130 F548 Neuro Muscular Advisor 2 1 50.00

130 MN Medicine Service Group - Dir 130 F549 MND Project 3 2 66.67

130 MN Medicine Service Group - Dir 130 F550 MN Neurology Amulatory Unit 3 1 33.33

130 MN Medicine Service Group - Dir 130 N071 MN Ward F 38 25 65.79

130 MN Medicine Service Group - Dir 130 N076 MN Elderly Care 5 5 100.00

130 MN Medicine Service Group - Dir 130 N206 Acute Medical Assessment Unit (West) 42 26 61.90

130 MN Medicine Service Group - Dir 130 P421 MN Outpatients Clinics 17 12 70.59

130 MN Medicine Service Group - Dir 130 R082 MN Psychology (Neuro) 8 8 100.00

130 MN Surgery Service Group - Dir 130 A420 Laser Service 2 1 50.00

130 MN Surgery Service Group - Dir 130 C101 MN Tertiary Cardiology Med Specialty 5 0 0.00

130 MN Surgery Service Group - Dir 130 C102 West Secondary Cardiology Med Spec 3 3 100.00

130 MN Surgery Service Group - Dir 130 C111 MN Cardiac Surgery Medical Specialty 4 1 25.00

130 MN Surgery Service Group - Dir 130 C207 Cardiac Specialist Nurses 7 3 42.86

130 MN Surgery Service Group - Dir 130 C211 MN Cardiac ITU/HDU 96 69 71.88

130 MN Surgery Service Group - Dir 130 C212 MN CC 28 13 46.43

130 MN Surgery Service Group - Dir 130 C214 MN Dan Danino Ward 25 6 24.00

130 MN Surgery Service Group - Dir 130 C215 MN Cyril Evans Ward 42 16 38.10

130 MN Surgery Service Group - Dir 130 C216 MN Cardiac Perfusion (Cardiac) 10 1 10.00

130 MN Surgery Service Group - Dir 130 C217 MN Cardiac Catheter Laboratory & Short Stay Unit 24 8 33.33

130 MN Surgery Service Group - Dir 130 C302 Cardiac Directorate Support 26 19 73.08

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130 MN Surgery Service Group - Dir 130 C411 SN ECG 14 0 0.00

130 MN Surgery Service Group - Dir 130 C412 MN ECG 40 18 45.00

130 MN Surgery Service Group - Dir 130 E102 MN Surgery Services Group Support 28 11 39.29

130 MN Surgery Service Group - Dir 130 E103 Surgery Directorate Admissions/RTT 23 15 65.22

130 MN Surgery Service Group - Dir 130 E201 West General Surgery CNS 14 12 85.71

130 MN Surgery Service Group - Dir 130 E203 West Urology CNS 8 5 62.50

130 MN Surgery Service Group - Dir 130 E206 Vascular CNS 5 4 80.00

130 MN Surgery Service Group - Dir 130 E302 West General Surgery Med Spec 25 21 84.00

130 MN Surgery Service Group - Dir 130 E413 Surgical Services Nursing Pool 16 13 81.25

130 MN Surgery Service Group - Dir 130 E414 MN Ward T 42 29 69.05

130 MN Surgery Service Group - Dir 130 E416 MN Ward H 36 33 91.67

130 MN Surgery Service Group - Dir 130 E417 MN Ward G 41 26 63.41

130 MN Surgery Service Group - Dir 130 E418 MN Ward V 50 43 86.00

130 MN Surgery Service Group - Dir 130 E419 MN SDMU / TAU 58 26 44.83

130 MN Surgery Service Group - Dir 130 E521 West Urology Medical Specialty 18 14 77.78

130 MN Surgery Service Group - Dir 130 E522 NPTH Urology Unit 9 7 77.78

130 MN Surgery Service Group - Dir 130 F318 Morriston Ward C 35 15 42.86

130 MN Surgery Service Group - Dir 130 G102 MSK Directorate Support 2 2 100.00

130 MN Surgery Service Group - Dir 130 G104 MSK West Site Operational Support 22 19 86.36

130 MN Surgery Service Group - Dir 130 G105 MN OP Appointment Centre 65 45 69.23

130 MN Surgery Service Group - Dir 130 G510 POA Service 2 2 100.00

130 MN Surgery Service Group - Dir 130 G511 MN Fracture Clinic 19 5 26.32

130 MN Surgery Service Group - Dir 130 G512 MN Ward W 28 4 14.29

130 MN Surgery Service Group - Dir 130 G513 MN Ward A Trauma Admissions Ward 41 24 58.54

130 MN Surgery Service Group - Dir 130 G514 MN Ward B 39 1 2.56

130 MN Surgery Service Group - Dir 130 G515 MN Ward J 41 3 7.32

130 MN Surgery Service Group - Dir 130 G517 MN MSK Nurse Practitioners 12 3 25.00

130 MN Surgery Service Group - Dir 130 G602 MSK Physiotherapy West 46 37 80.43

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130 MN Surgery Service Group - Dir 130 K101 Regional Surgery Directorate Support 5 2 40.00

130 MN Surgery Service Group - Dir 130 K106 Regional Services RTT Validation and Waiting List Teams 4 4 100.00

130 MN Surgery Service Group - Dir 130 K201 MN Burns Outreach Team 2 1 50.00

130 MN Surgery Service Group - Dir 130 K204 MN Powys Ward (B&P) 20 19 95.00

130 MN Surgery Service Group - Dir 130 K205 MN B&P Specialist Nursing 9 4 44.44

130 MN Surgery Service Group - Dir 130 K206 MN B&P Medical Specialty 23 20 86.96

130 MN Surgery Service Group - Dir 130 K207 MN B&P Outpatients 11 6 54.55

130 MN Surgery Service Group - Dir 130 K208 MN Burns Theatre 14 4 28.57

130 MN Surgery Service Group - Dir 130 K209 Morriston Tempest Ward (B&P) 35 17 48.57

130 MN Surgery Service Group - Dir 130 K210 Morriston Clydach Ward 29 16 55.17

130 MN Surgery Service Group - Dir 130 K211 Morriston Pembroke Acute Ward (B&P) 42 15 35.71

130 MN Surgery Service Group - Dir 130 K212 Morriston Dyfed Ward (B&P) 16 7 43.75

130 MN Surgery Service Group - Dir 130 K301 MN ALAC 6 4 66.67

130 MN Surgery Service Group - Dir 130 K302 Spinal Medical Specialty 13 5 38.46

130 MN Surgery Service Group - Dir 130 K305 ALAC Prosthetics 9 8 88.89

130 MN Surgery Service Group - Dir 130 K402 MN Ward R 39 28 71.79

130 MN Surgery Service Group - Dir 130 K403 West Vascular Surgery 10 9 90.00

130 MN Surgery Service Group - Dir 130 K501 POW Maxillo-facial Outpatients 3 1 33.33

130 MN Surgery Service Group - Dir 130 K506 MN OMFS 8 8 100.00

130 MN Surgery Service Group - Dir 130 K507 MN Maxillofacial Lab 15 14 93.33

130 MN Surgery Service Group - Dir 130 K508 MN Orthodontics 8 8 100.00

130 MN Surgery Service Group - Dir 130 K510 Cleft Lip & Palate Service 21 4 19.05

130 MN Surgery Service Group - Dir 130 K513 MN Head & Neck Outpatients 51 29 56.86

130 MN Surgery Service Group - Dir 130 K604 NPTH ENT Medical Specialty 2 2 100.00

130 MN Surgery Service Group - Dir 130 K606 MN ENT Medical Specialty 9 9 100.00

130 MN Surgery Service Group - Dir 130 K801 Regional Surgery Physio 6 6 100.00

130 MN Surgery Service Group - Dir 130 K802 Regional Surgery OT 8 7 87.50

130 MN Unit Management - Dir 130 6F40 Morriston Unit Management 17 5 29.41

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130 MN Unit Management - Dir 130 F332 Morriston Unit Governance Team 7 5 71.43

Grand Total 3,124 1,927 61.68

The Unit’s PADR position has improved significantly since March 2016 when it was 32.4%. At end of April 2018 it was 61.68%. which is a slight decrease from the previous month. The Unit recognises that this is still not at an acceptable level and aims to ensure that all available (excluding those on maternity & sick leave) staff have a PDAR to discuss their objectives and have feedback from their manager. PADR rates are monitored at the weekly business meeting. The Unit is working towards 70% of staff having received an annual PADR by the end of Q1.

Actions taken completed April/May Actions planned for June/July  Plans by Service Groups to increase compliance in  Continue to monitor PADR compliance at the weekly Hotspot areas are reviewed at the weekly business business meeting meeting.  Hotspot areas to provide a plan with a trajectory to reach  Any areas with 0% have provided a report to increase at least 50 % by Q1 compliance  PDR compliance to be monitored in Service Group performance meetings particularly focusing on areas below 50%.  Continue to provide managers with detailed compliance information for their area

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Part 5 - Statutory and Mandatory Training April 2018 Information Governance 55%

Competency Compliance % Hand Hygiene 90.5% Fire Safety Training 78.3% Infection Prevention and Control- Level 1 85.3% Violence and Aggression 66.8%

Manual Handling 76.9% MCA/DOLS 60.3%

Safeguarding 57.0%

POVA 67.8%

Actions taken completed April/May Actions planned for June/July  Mandatory/ Statutory &Information Governance compliance  Focus on Information Governance compliance at the weekly monitored at weekly business meeting business meetings  ESR self- serve promoted in Service Groups to enable staff to  Service Groups to provide plans to increase Information complete mandatory training on line. Governance compliance  IG Governance issues discussed at the local partnership  Continue to remind staff of the opportunities available to forum support completion of mandatory training  Targeted Improvement action plan for MCA/DOLS , Infection  Continue to provide managers with up to date completion Control and Hand Hygiene training through the Heads of rates for their areas. Nursing

The funded nursing establishment gaps is impacting on the units ability to release staff to undertake mandatory & statutory training

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Part 6 - Variable Pay

The table below summaries the key elements of the variable pay trends for this year to date

LHB PAYBILL TREND

Cost Centre=MXXX (Morriston Delivery Unit) Period P01-19 ------

PAYBILL - FIXED 13,037,462.52 PAYBILL - BANK 95,209.45 PAYBILL - OVERTIME 210,205.12 PAYBILL - AGENCY NON MEDICAL 242,985.74 PAYBILL - AGENCY MEDICAL 111,701.82 PAYBILL - WLI 151,112.99 PAYBILL - IRREGULAR ADHs/SESSIONS 245,981.78 PAYBILL - TOTAL VARIABLE 1,057,196.90 ------TOTAL PAYBILL 14,094,659.42

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------Variable pay as a % of fixed pay 8.11

ADMINISTRATIVE & CLERICAL 1,027,518.94 MEDICAL & DENTAL 5,541,198.78 NURSING & MIDWIFERY 4,899,097.04 PROF SCIENTIFIC AND TECHNICAL 263,946.75 ADDITIONAL CLINICAL SERVICES 1,242,181.78 ALLIED HEALTHCARE PROFESSIONALS 659,486.68 HEALTHCARE SCIENTISTS 235,252.10 ESTATES & ANCILLIARY 225,977.35 STUDENTS 0.00 ------TOTAL PAYBILL 14,094,659.42 ------

Actions taken completed April/May Actions planned for June/July  Process for Agency Cap breaches for Medical and Dental  Continue to recruit to medical/nursing vacancies. Staff reviewed at the weekly Workforce panel.  Particular focus on recruiting to Medical posts in ED.  Rota co-ordinators workshop established to ensure  Actions contained within individual service group workforce compliance with the Agency cap process. plans to be implemented.  New bank system continues to be embedded within the HB.  Nursing shift standardisation consultation ended on 8th May  Service and Medicine group nurse rostering meetings 2018.To be introduced in September 2018 continue with April and May’s rosters inputted on new  Nurse designed tool kit to support the rostering process being spreadsheet. introduced into Surgical services and medicine.

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APPENDIX 1

 Review of sickness absence rates at the weekly business  On- going focus on robust sickness management meeting . Continue to reconcile MEDACS information with rota co-  Monthly open day recruitment events for nursing vacancies. ordinator input. Administration of the additional medical  Reconciling MEDACS information with rota co-ordinator input cover to identify anticipated service level pressures. Administration of the additional medical cover to identify anticipated service level pressures .

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Neath Port Talbot Delivery Unit

Part 1 – Sickness Absence 1 April 2017 – March 2018

Rolling 12 Month Short term/Long term

The rolling 12 month sick absence rate has increased by Both long term and short term sickness has 0.13% in the last month. The in month figure has decreased in March. Long term has decreased decreased by 0.61%. by 0.34% and short term has decreased by 0.27%

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Length of Absence

Overall performance February 2018 There has been a slight decrease in the in month figure and a slight increase in the overall cumulative sickness figure.

In month +/- on previous month Cumulative +/- on previous month Neath Port Talbot 5.31% -0.61% 4.93% + 0.13%

Actions taken completed Actions planned Rolling programme of deep dives arranged.  Continue deep dive into sickness with all the unit managers, to discuss the cases and action plans for each case, rolling programme  Review the sickness management process for Nursing sickness. Ensure correct documentation is in use, staggered process to move management of sickness to ward managers

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APPENDIX 1

Part 2 – Establishment, Vacancies and Recruitment

Over the last year or so we have been developing the ESR system to include an “establishment” figure so that we are able to accurately assess the number of true vacancies at any given time. The work has focused on our operational directorates and in particular nursing given the shortage of qualified nurses available within the employment market.

Budget SIP Detail -Under / Over Directorate Staff Category Wte FTE Establishment Neath Port Talbot Delivery Unit Admin & Clerical 165.22 158.25 -6.97 Consultant 16.03 15.60 -0.43 Other 645.67 657.83 12.16 Other Medical Staff 23.67 16.40 -7.27 Qualified Nurse 308.01 295.26 -12.75 Unqualified Nurse 125.16 123.03 -2.13 Neath Port Talbot Delivery Unit Totals 1,283.76 1,266.37 -17.39

Nursing and HCSW vacancies on hold due to public and staff engagement about the proposals to re - design services

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Part 3 - Turnover & Labour Stability Period Turnover Rate – 1 May 2017 – 30 April 2018

Staff Group FTE

Add Prof Scientific and Technic 9.72%

Additional Clinical Services 8.36% Turnover Rate FTE (12m) 9.60% Administrative and Clerical 7.77% 9.40% Allied Health Professionals 10.84% 9.20% Healthcare Scientists 2.58% 9.00% Medical and Dental 7.84% 8.80% Nursing and Midwifery Registered 9.46% 8.60%

8.40% 8.20% Overall Rate FTE 8.00% 130 SDU - Neath Port Talbot 9.24% Hospital 7.80% 1 2 3 4 5 6 7 8 9 10 11 12

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Part 4 - PADR

Current Position and Background The following provides a breakdown of the PADR completion and recording within ESR, as of the 30th April 2018 for a 12 month rolling period. Org L6 Org L8 Assignment Reviews Reviews Completed Count Completed % 130 Integrated Medicine Management - Dir 130 D501 POW Pharmacy 63 51 80.95 130 Integrated Medicine Management - Dir 130 D502 NPTH Pharmacy 33 21 63.64 130 Integrated Medicine Management - Dir 130 D503 NPTH Pharmacy - Prepack Service 5 3 60.00 130 Integrated Medicine Management - Dir 130 D511 SN Pharmacy 64 26 40.63 130 Integrated Medicine Management - Dir 130 D512 MN Aseptic Suite 8 7 87.50 130 Integrated Medicine Management - Dir 130 D513 CC Pharmacy 16 15 93.75 130 Integrated Medicine Management - Dir 130 D514 SN PTS 24 17 70.83 130 Integrated Medicine Management - Dir 130 D515 MN Pharmacy 92 42 45.65 130 Integrated Medicine Management - Dir 130 U030 Medicines Management Strategy 8 4 50.00 130 Integrated Medicine Management - Dir 130 V034 Prescribing Advice Support 8 6 75.00 130 Integrated Medicine Management - Dir 130 V035 Prescribing Hub 5 4 80.00 130 Integrated Medicine Management - Dir 130 W005 Drugs Prescribing 12 5 41.67 130 Integrated Medicine Management - Dir 130 W353 Integrated Medicines Management 5 5 100.00 130 Integrated Medicine Management - Dir 130 W360 Smoking Cessation Team 5 5 100.00 130 Integrated Medicine Management - Dir 130 W365 Primary Care Funded Pharmacists 2 0 0.00 130 Maternity - Dir 130 H401 NPTH Womens Health Clinic 12 6 50.00 130 Maternity - Dir 130 H431 NPTH Birth Centre 40 34 85.00 130 Maternity - Dir 130 H437 West Community Midwives - South Team 37 34 91.89 130 Maternity - Dir 130 H438 Bridgend Community Midwives 31 28 90.32 130 Maternity - Dir 130 H445 Obstetric Specialist Nurses 29 18 62.07 130 Neath Port Talbot Hospital Management - Dir 130 6F42 Neath Port Talbot Unit Management 6 4 66.67 130 Neath Port Talbot Hospital Management - Dir 130 N113 NPT Nurse Management & Quality 8 5 62.50 130 Nurse Bank & Education - Dir 130 6A03 Practice Facilitation 11 9 81.82 130 Nurse Bank & Education - Dir 130 6A04 Clinical Education 1 1 100.00 130 Nurse Bank & Education - Dir 130 6C32 HCSW 6 5 83.33 130 Nurse Bank & Education - Dir 130 P428 Nurse Bank Administration 11 6 54.55 130 Ops & Site Management - Dir 130 E403 NPTH Ward A 19 12 63.16 130 Ops & Site Management - Dir 130 F204 NPTH MIU 33 23 69.70 130 Ops & Site Management - Dir 130 F307 NPTH General Medicine 4 3 75.00

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130 Ops & Site Management - Dir 130 F309 NPTH Ward D 41 26 63.41 130 Ops & Site Management - Dir 130 F310 NPTH Ward C 40 18 45.00 130 Ops & Site Management - Dir 130 F324 Nurse Specialist 13 3 23.08 130 Ops & Site Management - Dir 130 F350 Patient Flow 6 5 83.33 130 Ops & Site Management - Dir 130 F351 NPTH Nurse Practioners 11 9 81.82 130 Ops & Site Management - Dir 130 F543 NPTH Rehabilitation Medicine 2 2 100.00 130 Ops & Site Management - Dir 130 F547 NPTH Neuro-Rehab Ward 27 9 33.33 130 Ops & Site Management - Dir 130 G302 Rheumatology Medical Specialty 22 20 90.91 130 Ops & Site Management - Dir 130 G303 POW Rheumatology Day Unit 11 9 81.82 130 Ops & Site Management - Dir 130 G504 NPTH Fracture Clinic 13 11 84.62 130 Ops & Site Management - Dir 130 N011 NPTH Ward E 37 24 64.86 130 Ops & Site Management - Dir 130 N012 NPTH Elderly Day Hospital 7 4 57.14 130 Ops & Site Management - Dir 130 N013 NPTH Ward B2 33 22 66.67 130 Ops & Site Management - Dir 130 N060 NPTH Elderly Care 1 1 100.00 130 Ops & Site Management - Dir 130 N112 NPT Specialists 2 1 50.00 130 Ops & Site Management - Dir 130 P003 NPTH Outpatients 47 23 48.94 130 Ops & Site Management - Dir 130 P211 NPTH Administration 14 8 57.14 130 Ops & Site Management - Dir 130 P252 NPT Hospital Admin 9 8 88.89 130 Ops & Site Management - Dir 130 P254 Rapid Diagnostic Centre 3 2 66.67 130 Therapies - Dir 130 N025 East Dietetics 32 28 87.50 130 Therapies - Dir 130 N026 POW Occupational Therapy 39 38 97.44 130 Therapies - Dir 130 N027 NPTH Occupational Therapy 20 20 100.00 130 Therapies - Dir 130 N030 POW Physiotherapy 42 36 85.71 130 Therapies - Dir 130 N032 NPTH Physiotherapy 25 19 76.00 130 Therapies - Dir 130 N082 MN Occupational Therapy 70 67 95.71 130 Therapies - Dir 130 N083 West Community Occupational Therapy 26 22 84.62 130 Therapies - Dir 130 N090 Enhanced Nutrition & Dietetics Service 7 7 100.00 130 Therapies - Dir 130 N091 SN Dietetics 12 10 83.33 130 Therapies - Dir 130 N092 MN Dietetics 23 19 82.61 130 Therapies - Dir 130 N094 Dietetics WAG Initiative 8 8 100.00 130 Therapies - Dir 130 N095 West Community Physiotherapy 41 28 68.29 130 Therapies - Dir 130 N097 Swansea Physiotherapy 104 89 85.58 130 Welsh Fertility Institute - Dir 130 H412 South Wales IVF Service 18 11 61.11 130 Welsh Fertility Institute - Dir 130 H446 Embryology & Semenology 25 20 80.00 130 Welsh Fertility Institute - Dir 130 H448 WFI Admin 3 3 100.00 Grand Total 1,432 1,029 71.86

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APPENDIX 1

PADR Compliance v Target The unit’s position has shown a decrease 90 since the beginning of this year, with a 80 decrease of 0.85% since last month 70 60 50 % 40 30 20 10 0

Part 5 - Statutory and Mandatory Training

Information Governance/Statutory & Actions taken completed Mandatory training compliance  Steady increase in statutory and mandatory training, we expect this to continue as its an essential 100% requirement before our vacancy control panel sign 80% off any study leave requests 60%  Drop in sessions to support staff to undertake IG training continue 40% 20% 0% Actions planned Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18  Continue to remind staff of the opportunities IG Statutory available to support completion of mandatory training  Updated flow chart for study leave approval

Page 37 process

APPENDIX 1

Part 6 - Variable Pay

The Neath Delivery Unit’s variable pay spend, and the variable pay spend in comparison to substantive pay can be seen below:

Actions taken completed Actions planned  Agency Cap for Medical and Dental Staff introduced to  Continue to look to recruit to medical vacancies. support reduction in locum/agency usage and costs.  In conjunction with above advertise for additional ANP’s to join the medical rota to cover the gaps  Short term therapy locums in place to cover gaps to ensure RTT is met

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APPENDIX 1

Primary and Community Services Delivery Unit

Part 1 – Sickness Absence 1 April 2017 – 31 March 2018

Rolling 12 Month In Month Absence

The rolling 12 month sick absence rate has increased by 0.10% Short term and long term absence have decreased in February in the last month. The in month figure has decreased by 0.95%. Short term by 0.05% and Long term by 0.9%.

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APPENDIX 1

Overall performance March 2018 There has been a slight decrease in the in month figure and a slight increase in the overall cumulative sickness figure.

In month +/- on previous month Cumulative +/- on previous month PCS 5.55% -0.95% 5.69% + 0.10%

Actions taken completed March Actions planned for April/May  Confirm and challenge panels completed for all hotspot  Commencing meetings with all hotspot area sickness areas with addition of auditing sickness reporting and leads to discuss sickness levels ,offering advice on departmental systems issues raised and to talk about doing things differently .

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APPENDIX 1

Part 2 – Establishment, Vacancies and Recruitment

The information available on Business Intelligence stands as for March 18

Budget SIP Detail -Under / Over Directorate Staff Category Wte FTE Establishment Primary Care & Community Delivery Unit Admin & Clerical 239.79 217.29 -22.50 Consultant 13.50 11.50 -2.00 Other 374.24 341.07 -33.17 Other Medical Staff 40.83 42.55 1.72 Qualified Nurse 686.20 660.88 -25.32 Unqualified Nurse 258.38 245.24 -13.14 Primary Care & Community Delivery Unit Totals 1,612.94 1,518.53 -94.41

This shows as a slight decrease in vacancy levels from February 2018. (- 112.84)

Funded Staff in Vacancy (SIP - % under Nursing Vacancies Establishment Post Funded) establishment wte wte wte

Primary and Community Services DU Qualified 686.20 660.88 -25.32 -3.68% Unqualified 258.38 245.24 -13.14 - 5.08% Total 944.58 906.12 -38.46 - 4.07%

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APPENDIX 1

Part 3 - Turnover & Labour Stability

Staff Turnover - Primary Care & Community - 1 May 2017 – 30 April 2018 The average turnover rate for the Unit is 9.54% The rate has increased by 0.11 % in the last month

Staff Group FTE

Add Prof Scientific and Technic 28.03%

Additional Clinical Services 9.39%

Administrative and Clerical 10.52%

Allied Health Professionals 9.79%

Estates and Ancillary 52.17%

Healthcare Scientists 0.00%

Medical and Dental 19.08%

Nursing and Midwifery Registered 8.16% Students 0.00%

Overall Rate FTE 130 SDU - Primary Care & 9.54% Community

Actions taken completed March Actions planned for April/May  Leavers data is circulated on a monthly basis to all DUs.  DU to review exit interviews to establish if there are any patterns for staff leaving within the first year of their appointment.

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APPENDIX 1

Part 4 - PADR

Current Position and Background The following provides a breakdown of the Primary and Community Services Delivery Unit of PADR completion and recording within Electronic Staff Record (ESR) as a percentage, as of the 1st May 2017 – 30th April 2018

Staff Group Assignment Reviews Reviews Completed Count Completed % Add Prof Scientific and Technic 33 22 66.67 Additional Clinical Services 416 339 81.49 Administrative and Clerical 271 215 79.34 Allied Health Professionals 230 198 86.09 Estates and Ancillary 1 1 100.00 Healthcare Scientists 38 36 94.74 Nursing and Midwifery Registered 777 611 78.64 Students 2 0 0.00 Grand Total 1,768 1,422 80.43

Staff Group Assignment Reviews Reviews Completed Count Completed % Medical and Dental 53 15 28.30 Grand Total 53 15 28.30

The Unit’s position had improved month on month and has increased slightly since last month.

Unit Actions taken completed March Unit Actions planned for April  Ongoing close monitoring of rate and progress  Continue to offer support to ensure PADR’s are not only  Managers receiving regular updates with names of those undertaken but recorded. staff showing as non-compliant.  Maintain scrutiny to achieve target.

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APPENDIX 1

Part 5 - Statutory and Mandatory Training

The availability of up to date information on statutory and mandatory training compliance for the Delivery Unit has been highlighted to Informatics and the executive team

The performance scorecard has now been updated to reflect the % compliance for both Information Governance and all other training.

As at May 2018 ( April 2108 data) performance scorecard compliance shows :

Information Governance – 77 % compliance (slight increase from 76% March 18) All other mandatory and Statutory Training – 60.40% (slight increase from March 58.61%)

Actions taken completed March Actions planned for April  Mandatory training must be complete prior to any application  Continue to remind staff of the opportunities available to for study leave being considered support completion of mandatory training  Triumvirate steer to encourage staff to undertake IG training 

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APPENDIX 1

Section 6 – Variable Pay

Page 45

APPENDIX 1

Page 46

APPENDIX 1

Princess of Wales Delivery Unit

Part 1 – Sickness Absence April 2017 – March 2018

Rolling 12 month sickness absence – target 5%

2017 / 04 2017 / 05 2017 / 06 2017 / 07 2017 / 08 2017 / 09 2017 / 10 2017 / 11 2017 / 12 2018 / 01 2018 / 02 2018 / 03 Cumulative % Absence % Absence % Absence % Absence % Absence % Absence % Absence % Absence % Absence % Absence % Absence % Absence % Abs Rate (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE) (FTE)

130 SDU - Princess of Wales Hospital - Div Total 4.17% 4.74% 5.25% 5.02% 5.05% 4.67% 5.04% 5.10% 5.31% 6.34% 6.29% 5.36% 5.19% 130 POW Clinical Support Services - Dir Total 3.66% 4.04% 4.48% 4.93% 5.25% 5.31% 4.98% 4.55% 4.93% 5.78% 6.46% 5.03% 4.95% 130 POW Delivery Unit Management - Dir Total 9.68% 7.87% 9.53% 9.05% 7.84% 3.86% 3.61% 3.61% 4.90% 7.32% 10.74% 10.40% 7.28% 130 POW Emergency & Acute Medicine - Dir Total 3.32% 4.03% 4.79% 5.77% 5.06% 3.72% 4.41% 4.51% 3.74% 6.22% 5.91% 4.36% 4.65% 130 POW Medicine - Dir Total 4.27% 5.56% 5.81% 5.17% 5.21% 4.90% 4.94% 5.07% 4.45% 5.64% 4.96% 4.60% 5.05% 130 POW Patient Experience & Governance - Dir Total 0.00% 0.00% 0.00% 0.00% 0.63% 0.00% 0.00% 0.68% 0.33% 0.00% 9.84% 10.20% 1.78% 130 POW Site Management & Admin - Dir Total 3.59% 1.22% 3.29% 2.23% 2.19% 4.26% 1.06% 1.97% 7.40% 3.27% 2.85% 1.98% 2.94% 130 POW Surgical Services - Dir Total 4.58% 4.96% 5.54% 4.75% 4.84% 4.47% 5.75% 6.09% 6.93% 7.66% 7.32% 6.82% 5.80%

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APPENDIX 1

Rolling Absence Rate %

The in month sickness absence figure has reduced in the last month by 0.93%. The rolling 12 month figure increased by 0.06%. When compared to the March 2017 cumulative sickness absence rate of 5.46%, the unit’s cumulative sickness absence rate has reduced by 0.27% during the 12 month period

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APPENDIX 1

In Month Absence

Short term absence has decreased by 0.52% and long term absence decreased by 0.41% for March against the previous month sickness rates. Top reason for absence is Anxiety and Stress.

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APPENDIX 1

Length of Absence The chart below shows the length of absences.

Overall performance March 2018 There has been a decrease in month figure but a slight increase in the overall cumulative positon when compared to last month. However, the cumulative position has reduced by 0.27% when compared to March 2017.

In month +/- on previous month Cumulative +/- on previous month Princess of Wales 5.36% -0.93% 5.19% + 0.06%

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APPENDIX 1

Actions taken April/May Actions planned for June/July

 On-going implementation of unit’s Attendance  Continue with monthly service group sickness absence Improvement and Well-being action plan. meetings with unit managers, to discuss the cases and  Management Development – promotion of sickness review action plans for each case behavioural (Nelson) and Footprints training.  Further sick absence audits to continue within unit  Conclusion of some long standing employee relation during 2018. cases.  Review of medical staff sick absence reporting and  Continue with monthly service group sickness absence actions taken. meetings with unit managers, to discuss the cases and  On-going health promotion in main corridor review action plans for each case  On-going health and well-being focus in POW  On-going health and well-being focus in POW newsletter and team brief. newsletter and team brief.  Guy Holt and Paul Dunning to meet with managers  Time to Change Wales session delivered in Team Brief from areas that have the most improved sickness so in April– anti-stigma talk regarding mental health. the lessons can be shared across the Health Board.  Review of top 10 long term cases on a monthly basis  DU hot spot review on monthly basis  Implement actions from staff survey action plan  Implement actions from PADR improvement plan  Revised Improvement and Well-Being Action Plan to be developed within the unit for 2018-19.  Difficult conversation training – 3 sessions to be delivered in June for all managers.

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APPENDIX 1

Part 2 – Establishment, Vacancies and Recruitment

The information below shows the vacancies within the Delivery Unit as at 31 May 2018

Staff Group Budget WTE WTE (Under) / Over Vacancy % Establishment Total 1,815.86 1,652.32 (163.54) (9.01) Administrative & Clerical 259.61 251.78 (7.83) (3.01) Medical And Dental 312.01 257.04 (54.97) (17.62) Nursing And Midwifery Registered 750.86 668.28 (82.58) (11.00) Add Prof Scientific And Technical 38.10 38.15 0.05 0.14 Additional Clinical Services 317.68 307.01 (10.67) (3.36) Allied Health Professionals 111.49 105.00 (6.49) (5.82) Healthcare Scientists 18.73 18.04 (0.69) (3.68) Estates And Ancilliary 7.38 7.00 (0.38) (5.15)

Recruitment and retention of key staff groups- registered nursing and medical staff remain the key problem in terms of the level of vacancies and difficulties in recruitment and retention. The unit continues to recruit to medical and nursing vacancies and has recently introduced new roles, career opportunities and workforce models to attract and retain their future workforce. Nursing vacancies should improve due to the standardised shift patterns from June 2018.

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Part 3 - Turnover & Labour Stability

Staff Turnover - Princess of Wales Hospital - 1 May 2017 to 30 Apr 2018

2017 / 05 2017 / 2017 / 2017 / 2017 / 2017 / 2017 / 2017 / 2018 / 2018 / 2018 / 2018 / 06 07 08 09 10 11 12 01 02 03 04 Headcount 1,716 1,715 1,725 1,717 1,719 1,729 1,733 1,722 1,733 1,737 1,734 1,736 FTE 1,524.67 1,522.52 1,532.32 1,525.05 1,528.82 1,536.15 1,538.19 1,528.82 1,539.37 1,544.09 1,539.68 1,540.19 Leavers Headcount 13 12 15 17 15 12 7 14 7 3 13 10 Leavers FTE 11.60 10.76 13.45 14.65 13.41 10.32 5.93 11.44 5.53 2.61 10.17 7.66 Starters Headcount 13 13 16 4 19 20 10 6 15 5 5 14 Starters FTE 11.59 9.31 13.83 4.00 16.91 17.35 7.54 5.56 12.69 5.00 4.93 11.62 Maternity 35 37 41 40 43 42 41 44 38 36 38 38 Turnover Rate (Headcount) 0.76% 0.70% 0.87% 0.99% 0.87% 0.69% 0.40% 0.81% 0.40% 0.17% 0.75% 0.58% Turnover Rate (FTE) 0.76% 0.71% 0.88% 0.96% 0.88% 0.67% 0.39% 0.75% 0.36% 0.17% 0.66% 0.50% Leavers (12m) 213 207 204 200 180 167 162 161 157 152 148 138 Turnover Rate (12m) 12.23% 11.92% 11.77% 11.57% 10.43% 9.70% 9.40% 9.34% 9.11% 8.81% 8.58% 7.99% Leavers FTE (12m) 186.77 182.98 181.22 178.40 160.69 149.18 143.81 141.55 137.45 132.67 128.61 117.55 Turnover Rate FTE (12m) 12.10% 11.88% 11.79% 11.63% 10.49% 9.75% 9.39% 9.25% 8.98% 8.66% 8.39% 7.67%

Average turnover has decreased by 0.32% compared to last month’s cumulative rate. The overall rate has reduced significantly throughout the financial year from 12.10% in May 2017 to 7.67% in April 2018.

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Part 4 – PADR – target 85%

Current Position and Background

The following provides a breakdown of the Princess of Wales Delivery Unit PADR completion and recording within Electronic Staff Record (ESR) as a percentage, as of the 31st April 2018 for a 12 month rolling period.

PDR Reviews (excluding Medical & Dental) - SDU - Princess of Wales Hospital 1st May 2017 - 30th April 2018

Org L6 Org L8 Assignment Reviews Reviews Completed Count Completed % 130 POW Clinical Support Services - Dir 130 A101 POW Anaesthetics 2 1 50.00 130 POW Clinical Support Services - Dir 130 A110 East Pain Service 3 3 100.00 130 POW Clinical Support Services - Dir 130 A302 POW Critical Care 55 48 87.27 130 POW Clinical Support Services - Dir 130 A305 PWH Outreach 2 2 100.00 130 POW Clinical Support Services - Dir 130 A403 East Pre-Assessment 14 14 100.00 130 POW Clinical Support Services - Dir 130 A418 POW Theatres 122 40 32.79 130 POW Clinical Support Services - Dir 130 A419 NPTH Theatres 60 44 73.33 130 POW Clinical Support Services - Dir 130 A431 POW Theatre Support Staff & Management 6 1 16.67 130 POW Clinical Support Services - Dir 130 D602 POW Radiology 74 39 52.70 130 POW Clinical Support Services - Dir 130 D603 NPTH Radiology 52 24 46.15 130 POW Clinical Support Services - Dir 130 U505 Clinical Support Services - Management 5 5 100.00 130 POW Delivery Unit Management - Dir 130 6F45 POW Unit Management 5 1 20.00 130 POW Delivery Unit Management - Dir 130 F101 Medicine Clinical Support 8 7 87.50 130 POW Delivery Unit Management - Dir 130 N004 Discharge Lounge 4 2 50.00 130 POW Delivery Unit Management - Dir 130 P121 East Bed Management 7 4 57.14 130 POW Delivery Unit Management - Dir 130 P124 POW Discharge Liaison 5 5 100.00 130 POW Emergency & Acute Medicine - Dir 130 F201 POW Emergency Unit 74 31 41.89 130 POW Emergency & Acute Medicine - Dir 130 F202 POW AMU 54 51 94.44 130 POW Emergency & Acute Medicine - Dir 130 F203 POW Ambulatory Care 2 2 100.00 130 POW Emergency & Acute Medicine - Dir 130 F216 POW ED Medical Staff 14 2 14.29 130 POW Emergency & Acute Medicine - Dir 130 F306 POW Acute Care 3 3 100.00 130 POW Emergency & Acute Medicine - Dir 130 U502 Emergency & Acute Services Management 21 18 85.71

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130 POW Medicine - Dir 130 C103 POW Cardiology Medical Specialty 7 7 100.00 130 POW Medicine - Dir 130 C104 NPTH Cardiology Medical Speciality 2 2 100.00 130 POW Medicine - Dir 130 C201 POW Cardiac Unit 51 37 72.55 130 POW Medicine - Dir 130 C202 POW Cardiac Catheter Laboratory 12 10 83.33 130 POW Medicine - Dir 130 C401 POW ECG 22 2 9.09 130 POW Medicine - Dir 130 C402 NPTH ECG 6 1 16.67 130 POW Medicine - Dir 130 D302 POW Endoscopy Suite 22 18 81.82 130 POW Medicine - Dir 130 F301 POW Ward 2 29 16 55.17 130 POW Medicine - Dir 130 F302 POW Ward 6 33 25 75.76 130 POW Medicine - Dir 130 F303 POW Ward 5 33 21 63.64 130 POW Medicine - Dir 130 F304 POW Ward 17 16 0 0.00 130 POW Medicine - Dir 130 F305 POW Respiratory Medicine 10 4 40.00 130 POW Medicine - Dir 130 F327 POW Ward 20 35 26 74.29 130 POW Medicine - Dir 130 F500 POW Diabetic Clinic 5 5 100.00 130 POW Medicine - Dir 130 F501 POW Diabetology 2 2 100.00 130 POW Medicine - Dir 130 F520 POW Dermatology 10 5 50.00 130 POW Medicine - Dir 130 F530 POW Gastroenterology 3 2 66.67 130 POW Medicine - Dir 130 K706 Singleton Orthoptics 9 7 77.78 130 POW Medicine - Dir 130 N001 POW Elderly Care 18 14 77.78 130 POW Medicine - Dir 130 N002 POW Ward 18 39 21 53.85 130 POW Medicine - Dir 130 N003 POW Ward 19 34 23 67.65 130 POW Medicine - Dir 130 N005 POW Day Medical Unit 13 8 61.54 130 POW Medicine - Dir 130 P004 POW Outpatients 13 13 100.00 130 POW Medicine - Dir 130 U503 Medical Services - Management 12 5 41.67 130 POW Patient Experience & Governance - 130 U027 Clinical Governance 10 5 50.00 Dir 130 POW Site Management & Admin - Dir 130 P120 POW Hospital Admin 5 4 80.00 130 POW Site Management & Admin - Dir 130 P130 POW Bridgend Clinic 20 12 60.00 130 POW Site Management & Admin - Dir 130 U353 POW Site Management & Administration 6 0 0.00 130 POW Surgical Services - Dir 130 E202 East General Surgery CNS 9 6 66.67 130 POW Surgical Services - Dir 130 E204 East Urology CNS 10 10 100.00 130 POW Surgical Services - Dir 130 E205 ENT CNS 3 2 66.67 130 POW Surgical Services - Dir 130 E208 Singleton Breast Services 6 4 66.67 130 POW Surgical Services - Dir 130 E210 Breast Services - Medical staff 9 8 88.89 130 POW Surgical Services - Dir 130 E301 East General Surgery Medical Specialty 11 5 45.45 130 POW Surgical Services - Dir 130 E401 POW Ward 7 35 29 82.86 130 POW Surgical Services - Dir 130 E402 POW Ward 8 28 13 46.43 130 POW Surgical Services - Dir 130 E404 POW Short Stay Unit 15 5 33.33

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130 POW Surgical Services - Dir 130 E511 East Urology Medical Specialty 8 7 87.50 130 POW Surgical Services - Dir 130 G405 MSK East Site Operational Support 16 10 62.50 130 POW Surgical Services - Dir 130 G500 MSK Nurse Practitioners 9 7 77.78 130 POW Surgical Services - Dir 130 G501 POW Ward 10 35 29 82.86 130 POW Surgical Services - Dir 130 G502 POW Ward 9 36 16 44.44 130 POW Surgical Services - Dir 130 G503 POW Fracture Clinic 14 12 85.71 130 POW Surgical Services - Dir 130 G601 MSK Physiotherapy East 24 22 91.67 130 POW Surgical Services - Dir 130 H403 POW Ward 11 28 7 25.00 130 POW Surgical Services - Dir 130 H404 POW Womens Health Clinic 11 10 90.91 130 POW Surgical Services - Dir 130 H421 POW Obs & Gynae Medical Staff 6 5 83.33 130 POW Surgical Services - Dir 130 H426 Obs and Gynae Admin 11 0 0.00 130 POW Surgical Services - Dir 130 H432 POW Maternity 83 49 59.04 130 POW Surgical Services - Dir 130 K601Cochlear Implant Team 3 2 66.67 130 POW Surgical Services - Dir 130 K602 POW ENT Medical Specialty 4 3 75.00 130 POW Surgical Services - Dir 130 K701 POW Orthoptics 11 10 90.91 130 POW Surgical Services - Dir 130 K702 POW Ophthalmology Medical Specialty 6 6 100.00 130 POW Surgical Services - Dir 130 K703 POW Ophthalmolgy Clinic 14 8 57.14 130 POW Surgical Services - Dir 130 P007 POW Outpatients - Admin 33 22 66.67 130 POW Surgical Services - Dir 130 U504 Surgical Services - Management 15 10 66.67 Grand Total 1,562 959 61.40

The Unit’s PADR position has improved slightly over the last few months to 61%. The PADR rates are an on-going concern for the unit and improvements have been made in a number of areas. Plans are in place to further improve this position in the forthcoming months.

Actions taken completed April/May Actions planned for June/July  Re-training/training of ESR Learning Administrators  Continue to implement actions from PADR improvement undertaken to centrally input and report on PADR dates. plan.  PADR improvement plan agreed and implemented.  PADR training for managers

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Part 5 - Statutory and Mandatory Training – Target 85%

Statutory and Mandatory Training compliance by competence for Princess of Wales Delivery Unit as at 31st May 2018

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Statutory and Mandatory Training Compliance by staff group CSTF + MANDATORY Training Compliance - SDU - Princess of Wales @ 31 May 2018

Staff Group Assignment Count Required Achieved Compliance %

Add Prof Scientific and Technic 41 533 364 68.29%

Additional Clinical Services 357 4641 2781 59.92%

Administrative and Clerical 291 3783 2058 54.40%

Allied Health Professionals 117 1521 1158 76.13%

Estates and Ancillary 7 91 44 48.35%

Healthcare Scientists 20 260 215 82.69%

Medical and Dental 269 3497 1011 28.91%

Nursing and Midwifery Registered 752 9776 5797 59.30%

CSTF + MANDATORY Training Compliance - SDU - Princess of Wales @ 31 May 2018

Assignment Count Required Achieved Compliance % 1854 24102 13428 55.71%

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Statutory and Mandatory Training compliance by Service Group as at 31 May 2018

Service Group Assignment Required Achieved Compliance Count % 130 POW Clinical Support Services - Dir 461 5993 4176 69.68% 130 POW Delivery Unit Management - Dir 28 364 177 48.63% 130 POW Emergency & Acute Medicine - Dir 206 2678 1464 54.67% 130 POW Medicine - Dir 515 6695 3585 53.55% 130 POW Patient Experience & Governance - Dir 10 130 74 56.92% 130 POW Site Management & Admin - Dir 31 403 135 33.50% 130 POW Surgical Services - Dir 603 7839 3817 48.69%

Actions taken completed April/May Actions planned for June/July  Mandatory training must be completed prior to any  Improve PADR compliance rates/reviewing of statutory application for study leave being considered mandatory training  Roll out of violence and aggression training in ED, plan  On-going review of nursing rosters to maximise study to reach out to further service areas in quarter 1 2018. leave availability and attendance.  Monthly nurse rostering meetings– study leave KPI’s  Statutory and Mandatory training information to be reviewed with ward managers included in workforce HMC paper.

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Part 6 - Variable Pay

The table below summaries the key elements of the variable pay trends for this year to date

P01 BUDGET 7,151,866 VACANCY (738,316) TOTAL FIXED 6,413,550 Bank 126,680 Overtime 86,334 Agency - Non Medical 163,054 Agency - Medical 268,739 WLI 68,580 Irregular Sessions 97,300 TOTAL VARIABLE 810,687 TOTAL PAYBILL 7,224,237 Variable Pay of Total Pay % 11.22% Variable Pay of Vacancy % 109.80%

Increase in medical agency costs compared to last year due to backfill for rota gaps and sickness cover. There should be an improved nursing position due to the standardisation of shift patterns from June 2018.

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Actions taken completed April/May Actions planned for June/July  Monthly service group nurse rostering meetings continue  Continue to recruit to medical/nursing vacancies.  Monthly service group sickness meetings continue  Nursing shift standardisation to commence in June 2018  High level of nursing/medical vacancies  Pay cost pressures from variable pay to be managed  Review of medical job plans/rota commitment through cost reduction action plan  Monthly recruitment events for nursing vacancies  On- going focus on robust sickness management  Implement nursing shift standardisation in line with  Review of medical sickness timescales of the consultation

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Singleton Delivery Unit

Part 1 – Sickness Absence April 2017 – March 2018

Rolling 12 Month In Month Absence

. The sickness absence cumulative rate for the Unit as at In the Unit, the greater proportion of sickness absence continues to be March 2018 was 5.61%. made up of long term sickness absence. April 2017 until November 17 there was an overall increase in long sickness, this sickness has slightly decreased since then. From April 2017 we observed an increase in the short term sickness rates in the Unit, however in the month February – March 2018 this decreased

by 0.67%

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Length of Absence The chart below shows that the majority of absences are between 28 days and 6 months. This is a similar pattern to that over the last 12 months.

Delivery Unit performance Sept 17 to January 2018

In month +/- on previous month Cumulative +/- on previous month Sept 2017 4.93% 5.22% Oct 2017 6.64% +1.71% Nov 2017 5.95% - 0.69% Dec 2017 6.58% +0.63% January 2018 7.06% +0.48% 5.43% +0.21% from Sept February 2018 6.95% -0.11 % March 2018 6.16% -0.79 % 5.61% +0.18% from January

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Actions taken to date Actions planned for June/July . The Senior HR Manager and Cancer Services management team . Continuing review of the ten longest ‘long term’ sick cases – the continue to scope out a pilot project in conjunction with HR team continue to work alongside managers to review the ‘Maggie’s’ to introduce clinical supervision to support employee management of long terms sick cases via the Unit’s HR wellbeing within cancer services. Governance process. . Operational HR team and SHRMs will start to closely monitor . The HR Governance arrangements. The Unit’s Service Group and review the case management of the top 15 ‘28 day-6 management teams continue to work with the HR team to month’ sickness cases in the Unit (as this is appears to be a review analyse and act on the HR workforce data that is problem area) provided on a monthly basis. . Shared learning from approach taken in PoW (involve the . The Unit continues to encourage all employees with line Ward Managers in sickness management performance – management responsibility to attend the following previously focus in Medicine and USC was on Matrons and development opportunities: Footprints (Band 4-7), Coaching for Senior Matrons): IMPACT, PADR Training. Pilot run in Medicine and USC: Merge the previous HR Rolled out of sickness procedure training for mangers From the Governance meeting with the KPI meeting. Previously ward training it is expected that managers will gain the following managers were not involved in process. Details: knowledge / skills: . Ward Manager and Matron now meet with Finance / . Understanding of their role in managing attendance Business Hub / HR . Clear understanding of what support available . Ward Manager presents following information: . Gain Practical skills and knowledge through examples of Resources (establishment) / Rostering / Sickness sickness absence cases management data

. Group agree on remedial actions to improve performance

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Part 2 – Establishment, Vacancies and Recruitment –April 2018

ABM Finance Dashboard Summary of Vacancy Details for Singleton SDU April 2018 Data Summarised by Staff Category

Budget SIP Detail -Under / Over Directorate Staff Category Wte FTE Establishment Singleton Delivery Unit Admin & Clerical 330.71 319.54 -11.17 Consultant 141.90 125.35 -16.55 Other 483.10 465.39 -17.71 Other Medical Staff 177.93 161.86 -16.07 Qualified Nurse 785.23 725.04 -60.19 Unqualified Nurse 328.28 352.27 23.99 Singleton Delivery Unit Totals 2,247.15 2,149.45 -97.70

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Part 3 - Turnover & Labour Stability Staff Turnover - Singleton Hospital - 1 May 2017 to 30 Apr 2018

Staff Group FTE Average turnover has continued to decrease over the last few Add Prof Scientific and Technic 0.00% months. The average rate over the last 12 months has been 8.11% Additional Clinical Services 8.45% Administrative and Clerical 6.02% a slight decrease from the last time it was reported at 8.2%

Allied Health Professionals 4.73% Nursing and midwifery is the highest turnover rate at 9.97% Estates and Ancillary 0.00% . Healthcare Scientists 4.02% Medical and Dental 9.65% . Nursing and Midwifery Registered 9.97%

Staff Turnover - Singleton Hospital - 1 May 2017 to 30 Apr 2018

Overall Rate FTE 130 SDU - Singleton Hospital 8.11%

Actions taken to date Actions planned for June / July  Leaver’s data is circulated on a monthly basis to all Continue to promote staff engagement via:- Localities as part of the DU HR report to Board. Singleton team brief  All Leavers forms are checked for any outstanding Singleton Stronger Together events the theme for the issues June event is Theme: Compassionate and collective Leadership and Resilience (to support effective change management) Continuing to promote staff wellbeing events such as the staff Advice and support services”

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Part 4 – PADR

Current Position and Background The following provides a breakdown by Singleton Services Delivery Unit cost centre PADR completion and recording within Electronic Staff Record (ESR) as a percentage, as of the 25th May 2018.

Org L6 Org L8 Assignment Reviews Reviews Count Completed Completed % 130 SN Acute GP/MIU - Dir 130 F208 SN Minor Injuries Unit 5 2 40.00 130 SN Cancer Services - Dir 130 B101 SN Haematology Medical Specialty 11 2 18.18 130 SN Cancer Services - Dir 130 B120 SN Oncology Medical Specialty 14 1 7.14 130 SN Cancer Services - Dir 130 B201 SN CANTORIS 23 5 21.74 130 SN Cancer Services - Dir 130 B202 SN Radiotherapy Department 46 15 32.61 130 SN Cancer Services - Dir 130 B301 SN Ward 11 Haematology Day Unit 21 19 90.48 130 SN Cancer Services - Dir 130 B302 Anticoagulation Nursing 6 6 100.00 130 SN Cancer Services - Dir 130 B303 Haematology Specialist Nursing 9 4 44.44 130 SN Cancer Services - Dir 130 B310 SN Radiotherapy Nursing 8 7 87.50 130 SN Cancer Services - Dir 130 B311 SN Cancer Genetics 7 1 14.29 130 SN Cancer Services - Dir 130 B312 SN Chemotherapy Day Unit 16 10 62.50 130 SN Cancer Services - Dir 130 B313 SN Ward 12 (Oncology) 45 26 57.78 130 SN Cancer Services - Dir 130 B314 Oncology Specialist Nursing 14 13 92.86 130 SN Cancer Services - Dir 130 B315 Triage Service 4 0 0.00 130 SN Cancer Services - Dir 130 B320 POW Y Bwthyn Newydd 35 25 71.43 130 SN Cancer Services - Dir 130 B321 MN Ty Olwen Charitable Trust 9 9 100.00 130 SN Cancer Services - Dir 130 B322 MN Ty Olwen 47 44 93.62 130 SN Cancer Services - Dir 130 B330 SN Cancer Institute 5 4 80.00 130 SN Cancer Services - Dir 130 B401 Swansea Lymphodaema Service 16 12 75.00 130 SN Cancer Services - Dir 130 B402 Oncology Rehabilitation 4 2 50.00

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130 SN Cancer Services - Dir 130 B403 National Lymphoedema Specialist 7 4 57.14 Nurses 130 SN Cancer Services - Dir 130 B502 Cancer Directorate Support 14 3 21.43 130 SN Childrens Services - 130 H201 WCS Management Team 11 3 27.27 Dir 130 SN Childrens Services - 130 H501 Bridgend Community Paediatrics 1 1 100.00 Dir 130 SN Childrens Services - 130 H503 West Paediatric Continuing Care 63 52 82.54 Dir Pool 130 SN Childrens Services - 130 H510 POW Paediatrics Medical Staff 1 1 100.00 Dir 130 SN Childrens Services - 130 H512 Paediatrics Secretaries 38 34 89.47 Dir 130 SN Childrens Services - 130 H522 NPTH Paediatric OPD 3 3 100.00 Dir 130 SN Childrens Services - 130 H524 POW Paediatric Ward 38 20 52.63 Dir 130 SN Childrens Services - 130 H526 MN Oakwood OPD 5 1 20.00 Dir 130 SN Childrens Services - 130 H528 Singleton Paediatrics OPD 7 5 71.43 Dir 130 SN Childrens Services - 130 H531 West Child Health Appointment 29 28 96.55 Dir Admin 130 SN Childrens Services - 130 H532 MN Oakwood Ward (Green) 43 28 65.12 Dir 130 SN Childrens Services - 130 H534 MN Paediatric Assessment Unit 19 12 63.16 Dir 130 SN Childrens Services - 130 H536 Neurodevelopmental and Learning 4 4 100.00 Dir Disability Services

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130 SN Childrens Services - 130 H537 Peadiatric Diabetic Service - Peer 3 2 66.67 Dir Review 130 SN Childrens Services - 130 H539 MN Oakwood Paeds (Ward M) 24 13 54.17 Dir 130 SN Childrens Services - 130 H541 POW SCBU. 26 21 80.77 Dir 130 SN Childrens Services - 130 H542 SN Neo-Natal Intensive Care Unit 95 56 58.95 Dir 130 SN Childrens Services - 130 H550 Paediatric Specialist Nurses 17 16 94.00 Dir 130 SN Childrens Services - 130 H551 Neonates Medical Specialty 5 1 20.00 Dir 130 SN Childrens Services - 130 N111 CHC Bridgend Heronsbridge 1 1 100.00 Dir 130 SN Clinical Support 130 D401 SN General Medical Physics 12 12 100.00 Services - Dir 130 SN Clinical Support 130 D402 SN Medical Electronics 8 6 75.00 Services - Dir 130 SN Clinical Support 130 D410 MN Renal Technical Support 5 1 20.00 Services - Dir 130 SN Clinical Support 130 D411 MN Medical Electronics 20 14 70.00 Services - Dir 130 SN Clinical Support 130 D412 Clinical Engineering 3 3 100.00 Services - Dir 130 SN Clinical Support 130 D413 SN Mechanical Engineering 1 1 100.00 Services - Dir 130 SN Clinical Support 130 D414 Rehab Engineering 9 7 77.78 Services - Dir

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130 SN Clinical Support 130 D415 NPTH Medical Electronics 7 7 100.00 Services - Dir 130 SN Clinical Support 130 D420 SN Nuclear Medicine 19 13 68.42 Services - Dir 130 SN Clinical Support 130 D450 SN Radiotherapy Physics 25 23 92.00 Services - Dir 130 SN Clinical Support 130 D460 SN Radiation Protection 5 5 100.00 Services - Dir 130 SN Clinical Support 130 J101 Pathology Directorate Support 1 0 0.00 Services - Dir 130 SN Clinical Support 130 J102 West Pathology Support 52 28 53.85 Services - Dir 130 SN Clinical Support 130 J106 Point of Care Testing 7 0 0.00 Services - Dir 130 SN Clinical Support 130 J108 Pathology Directorate Support 17 15 88.24 Services - Dir Admin 130 SN Clinical Support 130 J301 Cellular Pathology 80 33 41.25 Services - Dir 130 SN Clinical Support 130 J601 Laboratory Medicine 198 25 12.63 Services - Dir 130 SN Clinical Support 130 K202 West PUPIS 3 2 66.67 Services - Dir 130 SN Site Management - 130 6F41 Singleton Unit Management 14 10 71.43 Dir 130 SN Site Management - 130 P430 Total Bed Management Contract 1 0 0.00 Dir 130 SN Site Management - 130 P690 SN General Admin 5 3 60.00 Dir

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130 SN Site Management - 130 P692 SN Outpatients Clinics 16 6 37.50 Dir 130 SN Site Management - 130 W350 Swansea Locality Management 5 5 100.00 Dir 130 SN Site Management - 130 W352 Nursing 27 11 40.74 Dir 130 SN Surgical Services - Dir 130 A422 SN Theatres 88 53 60.23 130 SN Surgical Services - Dir 130 H202 WCH Directorate Support 2 0 0.00 130 SN Surgical Services - Dir 130 H203 WCS NPT Directorate Support 1 1 100.00 130 SN Surgical Services - Dir 130 H204 Women & Childrens Health Division 1 0 0.00 Management 130 SN Surgical Services - Dir 130 H402 NPTH Ward B1 11 8 72.73 130 SN Surgical Services - Dir 130 H407 SN Gynaecology OPD 13 7 53.85 130 SN Surgical Services - Dir 130 H408 Singleton Ward 20 (Gynaecology) 4 3 75.00 130 SN Surgical Services - Dir 130 H410 SN Colposcopy 12 0 0.00 130 SN Surgical Services - Dir 130 H411 Gynaecology Specialist Nurses 6 2 33.33 130 SN Surgical Services - Dir 130 H425 SN Obs & Gynae Medical Specialty 26 2 7.69 130 SN Surgical Services - Dir 130 H433 SN Ante-Natal Clinic 13 7 53.85 130 SN Surgical Services - Dir 130 H444 SN Maternity 157 92 58.60 130 SN Surgical Services - Dir 130 K605 SN Ward 2 50 36 72.00 130 SN Surgical Services - Dir 130 K704 NPTH Ophthalmology Medical 2 2 100.00 Specialty 130 SN Surgical Services - Dir 130 K705 SN Ophthalmology Medical 14 11 78.57 Specialty 130 SN Surgical Services - Dir 130 K707 SN Ophthalmology Outpatients 30 10 33.33 130 SN Surgical Services - Dir 130 K708 Outpatient Support Team 19 11 57.89 130 SN Site Management - 130 W357 Sing SDU Surgical Mgmt 6 3 50.00 Dir

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130 SN Unscheduled Care & 130 D301 NPTH Endoscopy Suite 23 14 60.87 Medicine - Dir 130 SN Unscheduled Care & 130 D311 Singleton Endoscopy Suite 20 13 65.00 Medicine - Dir 130 SN Unscheduled Care & 130 D312 MN Endoscopy Suite 19 12 63.16 Medicine - Dir 130 SN Unscheduled Care & 130 E411 SN Ward 4 42 37 88.10 Medicine - Dir 130 SN Unscheduled Care & 130 F211 SN SAU 42 32 76.19 Medicine - Dir 130 SN Unscheduled Care & 130 F312 SN Respiratory Medicine 6 3 50.00 Medicine - Dir 130 SN Unscheduled Care & 130 F321 Singleton Ward 9 30 21 70.00 Medicine - Dir 130 SN Unscheduled Care & 130 F322 SN Ward 8 38 31 81.58 Medicine - Dir 130 SN Unscheduled Care & 130 F328 SN Ward 6 35 25 71.43 Medicine - Dir 130 SN Unscheduled Care & 130 F331 Singleton Day Unit 9 7 77.78 Medicine - Dir 130 SN Unscheduled Care & 130 F503 SN Diabetology 10 8 80.00 Medicine - Dir 130 SN Unscheduled Care & 130 F523 SN Dermatology 14 8 57.14 Medicine - Dir 130 SN Unscheduled Care & 130 F532 SN Gastroenterology 4 4 100.00 Medicine - Dir 130 SN Unscheduled Care & 130 N061 SN Elderly Care Medical 4 4 100.00 Medicine - Dir

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130 SN Unscheduled Care & 130 N066 SN Ward 7 (Elderly Care) 28 22 78.57 Medicine - Dir 130 SN Unscheduled Care & 130 N077 SN Ward 3 (Elderly) 38 34 89.47 Medicine - Dir 130 SN Unscheduled Care & 130 N200 BBV Specialist Nurses 4 2 50.00 Medicine - Dir 130 SN Unscheduled Care & 130 W356 Sing SDU USC/Med Mgmt 9 6 66.67 Medicine - Dir 2,169 1,277 58.88%

Actions taken to date Actions planned for June / July . The Business Hub continues to provide managers with up to date . The HR Governance arrangements. The Unit’s Service Group completion rates for their areas. They are also providing detailed management teams continue to work with the HR team to reports that show the names of employees who have a current up review analyse and act on the HR workforce data that is to date PADR / a PADR that is due to expire in the next two months provided on a monthly basis. / or who have a PADR that has expired. . Going to add mandatory / statutory training compliance data from ESR to performance review packs which are sent to managers on a monthly basis / link to PADR’s

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Part 5 - Statutory and Mandatory Training – As per Performance Review Scorecard January 2018

MANDATORY TRAINING (NURSING STAFF ONLY- CARE METRICS) Apr-18 % Staff received Fire Safety training 96.4% % Staff received V&A training 93.1% % Staff received Manual Handling training 89.5% % Staff received Hand Hygiene training in last 12 months 94.6% % Staff received Standard precaution infection control training in last 12 months 94.9% % Staff received appropriate level of Safe Guarding children training (3 yrly) 96.8% % Staff received POVA training in last 3 years 93.4% % Staff trained in MCA/DOLS 92.4% MANDATORY TRAINING (All STAFF) % staff who have undergone information governance training as outlined in C-PIP 52% Guidance % compliance with mandatory and statutory training (all staff) 48.54%

Actions taken Actions planned for June / July  April / May data cleansing exercise around staff that have completed information governance.  Information Governance training compliance data has been sent to Service Managers and will form part of each service group’s performance review process within the unit

 Going to add mandatory / statutory training compliance data from ESR to performance review packs which are sent to managers on a monthly basis / link to PADR’s

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Part 6 - Variable Pay

The table below summaries the key elements of variable pay.

SSDU Medical Staff Variable Pay Medical Staff

Irregular Period Agency Medical Sessions P02 17/18 138,558 109647 P03 17/18 146,376 67456 P04 17/18 165,878 222069 P05 17/18 250,013 98559 P06 17/18 159,874 139383 P07 17/18 129,384 126401 P08 17/18 150,816 182433 P09 17/18 71,666 105472 P10 17/18 162,287 91975 P11 17/18 158,157 66284 P12 17/18 106,399 162397 P01 18/19 99,282 67850

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SSDU - Variable Pay Nursing

Agency Period Bank Overtime Nursing P02 17/18 94,873 53,429 72,707 P03 17/18 87,751 57,692 109,571 P04 17/18 106,032 52,752 144,367 P05 17/18 103,261 44,859 118,426 P06 17/18 103,401 68,551 53,026 P07 17/18 101,656 47,345 90,769 P08 17/18 111,567 46,104 129,012 P09 17/18 135,151 60,135 149,723 P10 17/18 160,435 53,840 161,439 P11 17/18 142,214 48,638 108,263 P12 17/18 129,645 68,343 159,475 P01 18/19 113,679 88,223 59,131

Actions taken to date Actions planned for June / July  Agency Cap for Medical and Dental Staff introduced to  Review standardised shift system for nursing across DU. support reduction in locum/agency usage and costs.

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